| NPI | 1255189577 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09930653) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO LSW.0009924511) |
| Enumeration Date | 2024-05-10 |
| Last Update Date | 2024-07-12 |